Abstract
AIM: Exploring how nursing home nurses who care for residents with dementia experience moral distress. DESIGN: A qualitative phenomenography design. METHODS: Phenomenography was used in this qualitative study. In-depth interviews were conducted with 20 nurses caring for residents with dementia at three nursing homes using phenomenographic analysis. RESULTS: Six categories were divided into two groups. The 'reflection on my nursing' group included the categories 'anguish over qualifications to care for residents', 'uncertainty about the adequacy of the care provided', and 'internal conflict over whether to compromise with unsatisfactory outcomes'. The 'moral awareness' group included 'being aware of deviations from the standards I set and the care I provide', 'recognising when I become insensitive to things I should not do', and 'ruminating about whether it would be okay if I have no choice'. Comprehensively, it was found that moral distress occurs when reflecting on nursing and moral awareness conflicts. CONCLUSION: This study provides insight into the various ways in which nursing home nurses experience moral distress when caring for residents with dementia. This study can provide a basis and direction for various strategies to reduce moral distress. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: Considering the growing interest in the moral distress experienced by nurses, along with the importance of the human rights of residents with dementia in an aging society, these research results will have a positive impact on improving the quality of care provided by nursing home nurses to residents with dementia. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: We have adhered to relevant COREQ guidelines.